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100 E Newton St Rm G-04 Boston MA 02118-2308 | |
| (617) 638-4775 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 100 E Newton St, Boston, Massachusetts |
| Authorized Official Name and Position | Jeffrey W. Hutter (DEAN AD INTERIM) |
| Authorized Official Contact | 6176384780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1167 Goldthwait Assoc C/o Bu Oral And Maxilofacial Pathology Marblehead MA 01945 Ph: (781) 631-8210 | 100 E Newton St Rm G-04 Boston MA 02118-2308 Ph: (617) 638-4775 |
| NPI Number | 1093993503 |
|---|---|
| Provider Enumeration Date | 02/06/2008 |
| Last Update Date | 02/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093993503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 4954 (Massachusetts) | Primary |
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